BIRMINGHAM, Alabama – The Alabama Supreme Court has declined to hear an appeal in the fight over Trinity Medical Center’s plan to relocate, clearing the way for Trinity to move to the unfinished HealthSouth hospital building on U.S. 280.

The decision brings to an end a five-year fight before regulators and the courts in which Brookwood Medical Center and St. Vincent’s Health System sought to block Trinity’s move.

“We are delighted to have an unappealable decision from the Supreme Court,” Trinity CEO Keith Granger said in an interview. “It’s been a long and arduous course.”

Once work begins it will take about two years to complete the hospital at a cost of about $280 million, Granger said.

Officials with Brookwood Medical Center, which had argued that a new Trinity would cost Brookwood $12 million to $17 million a year in lost business, said they were not pleased with the decision.

“We obviously are disappointed in the court’s ruling,” said Jim Williams, an attorney representing Brookwood. “However, we are respectful of the court.”

Attempts to reach an attorney representing St. Vincent’s were not successful. St. Vincent’s had indicated in filings that a new Trinity would cost it $3.4 million to $6.8 million a year.

Trinity CEO Keith Granger

Birmingham Mayor William Bell's Chief of Staff, Chuck Faush, praised the court’s ruling late today, saying the project will create construction jobs and have significant economic impact. Community leaders in the neighborhood surrounding the existing Montclair Road hospital, however, called on the city to help fill the void Trinity’s departure will leave behind.

Trinity has said the project will create 4,000 jobs during its first year of construction, and yield more than $3 million in city and county tax revenue. Lt. Gov. Kay Ivey and Business Council of Alabama President William Canary both said greater Birmingham will benefit from the ruling.

“This really is a win/win for the people of Alabama,” Ivey said in a prepared statement.

The dispute over Trinity’s plan had its roots in Trinity’s 2006 request to close its campus and build a new hospital in Irondale. The state’s Certificate of Need Review Board approved that plan in 2008, but four months later Trinity announced plans to buy the unfinished HealthSouth hospital on U.S. 280 and move there instead. Irondale leaders briefly discussed filing bankruptcy after Trinity’s change of plan, and sued the hospital. The suit was settled in 2011.

After unsuccessfully opposing Trinity’s new plan before regulators and an administrative law judge, Brookwood and St. Vincent’s sued Trinity in Circuit Court in 2010. Over the next two years the case made its way through the courts, ultimately reaching the Supreme Court in January of this year.

The core issues in the case included a dispute over the application of a state rule that says a hospital must be at least 60 percent occupied in order to win approval of a new facility, and a 1990 precedent involving the state’s denial of a similar request for a Shelby County hospital by the Lloyd Noland Foundation.

But the case also spun off a number of related disputes and served as a backdrop for loosely-related drama. In 2010 Trinity’s parent company, Community Health Systems, tried to take over Brookwood’s parent, Tenet Healthcare, in an unsuccessful $3 billion cash-and-stock bid. In 2011 Tenet sued CHS, accusing the company of unnecessarily admitting tens of thousands of patients in a scheme to defraud Medicare.

The proceedings also were highlighted by accusations that regulators had been improperly influenced, and that important evidence was improperly withheld.

Ultimately, though, the fight boiled down to a dispute over the Lloyd Noland case and a disagreement about whether regulators erred when they altered Trinity’s request for a Certificate of Need. Regulators had lowered the number of beds in the application to bring it in alignment with the so-called “60 percent rule” and make it consistent with the state’s formal health plan.

Five justices declined to hear the case without issuing an opinion. Justices Glenn Murdock and Greg Shaw dissented with respect to the Lloyd Noland precedent. One judge, Justice Tommy Bryan, who served on the Court of Civil Appeals when it heard the case, recused himself.